Aims There has been a focus on increasingly ‘sedentary lifestyles’ as a driver of rising child and adolescent obesity. The use of technology amongst young people has been often purported as a major contributor to this behaviour change. We examined technology through multiple lens, looking at the threats it brings, and how we can harness potential opportunities in the prevention and intervention of obesity.

Methods A literature review was performed using PubMed and the Cochrane Library databases, using various combinations of search terms including ‘child’, ‘adolescent’, ‘overweight’, obesity’, ‘BMI’, ‘BMI-z’, ‘technology’, ‘screen time’, ‘television’, ‘ehealth’, ‘mhealth’, ‘exergaming,’ ‘gamification’ and ‘wearables.’

Results Cross-sectional and longitudinal studies have identified a correlation between ‘screen time’ and increased likelihood that a child will be overweight or obese, as well as reduced physical activity and increased consumption of high energy and/or low nutrition quality foods. Multimedia food marketing has been shown to have a negative influence on children’s food choices and perceptions of nutrition. However, technologies can be manipulated for health promotion and to encourage behaviour change.

Technology can be integrated into existing programmes, making them more accessible, sustainable and individualised. Such integrated models have allowed both patients and professionals to track nutrition and lifestyle behaviours to identify opportunities for intervention and improve communication between these groups. Three systematic reviews identified ‘mhealth’ and ‘ehealth’ interventions in children, with none from low and middle-income countries. Diverse modalities exist, with mixed evidence behind their efficacy by physical activity, diet quality or body mass index (BMI) measures. A tailored approach is needed for different age groups or for family focused programmes, with variations in content required to ensure continued engagement. There has been a rapid expansion in the use of commercial ‘apps’, however little is known regarding the quality of these tools. One review assessing 383 apps identified a lack of evidenced-based methods, scientific evaluation, or healthcare professional involvement in design.

Conclusion There is limited robust evidence regarding the role of technology in childhood obesity. Guidelines and policy regarding ‘screen time’ and the use of technology is important to support healthcare professionals giving advice regarding healthy lifestyle measures.